2. Energy restricting diets alone should not be used for fat loss over an extended period as these lead to physiological adaptations which can counteract the fat loss.

3. Energy restriction below 1200kcal per day should not be used over an extended period except in special cases of supervised dietary restriction for severe obesity.

4. Except where contra-indicated, physical activity should play a significant role in long term maintenance of fat loss.

5. Resistance training may be indicated in the maintenance stage of a fat loss program to ensure a counterbalance to the adaptations that occur to slimming.

6. Clients who have been on very low energy diets for extended periods may need to be gradually re-fed until daily energy intake is around 1200-1500kcal per day.

7. Clients should be made aware that long term continuous fat losses will only occur with increased changes in energy balance and/or alterations to the type of food intake and energy output.

8. The proportion of LBM to fat loss following a diet is likely to be much higher in people with a lower initial body fat level, hence people who are only mildly overfat and who use dietary restriction alone to treat this, are actually likely to finish with an higher proportion of body fat than at the start of a slimming initiative.

9. Physical activity should form a more significant part of the initial fat loss and fat loss maintenance regimes of those with a relatively low fat to total body mass ratio.

10. Behaviour modification principles utilised for fat loss should be continued in the maintenance stage.

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Fats which are released into the bloodstream during lipolysis are liberated from their glycerol base and transported to the muscle via the blood to be used as fuel. However, more fat is usually released than is used up. At rest, it has been shown that about 70 per cent of fats released into the bloodstream are re-esterified back into the fat cell, but this decreases to about 25 per cent after the first 30 minutes of a low intensity exercise session. When the exercise is completed, some fats continue to be burned in the recovery process, but about 90 per cent of those released which have not been used up are then re-esterified, and stored back in the fat cell until another day. In exercise then, about one-half of the increase in fat oxidation contributing to the extra fuel supply comes from a reduction of the percentage of re-esterification (fats re-entering the fat cell), rather than an increase in fats being released from the fat cell.

The process of re-esterification may be important for the fat loss process as some studies have shown that the degree of re-esterification, in contrast to the extra fat used up, may be influenced by the post- and pre-exercise meal of the exerciser. Injecting glucose into a fasted subject for example, has been shown to increase the re-esterification of fats back into the fat cell more quickly than it inhibits lipolysis, possibly due to the increase in insulin following a glucose load which then has an inhibitory effect on lipolysis.

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How? By choosing foods that fill her up, not out.

Helen’s battle of the bulge began 65 years ago, when she was just 8 years old. At the time, she turned to food to help ease the pain of her mother’s death. That led to an unhealthy pattern of using food for comfort—and putting on pounds. She reached 180 pounds while a freshman in college and remained at that weight for years.

Even though she was heavier than she should have been, Helen didn’t worry about it. She never liked the idea of dieting. The prospect of giving up her favorite foods and eating less repeatedly dissuaded her from slimming down.

Then, one morning, everything changed. “When I woke up, I said to myself, ‘I’m tired of this/” Helen recalls. “I didn’t want to be heavy anymore. I wanted to be thin.”

Looking back? Helen realizes that her decision to lose weight had been brewing for some time. “I had grown unhappy with my appearance, and deep down, I wanted to be thin,” she says. “The time had come to do something about it, and I knew it.”

As she planned her weight-loss strategy, Helen admitted to herself that she would have a hard time changing her diet. So instead of trying to eat less, she ate differently. She sought out foods that would leave her feeling full without supplying a lot of fat or calories. Most of Helen’s lunches and dinners started out with a great big salad flavored with balsamic vinegar. She thought nothing of snacking on a big pink grapefruit, a whole cantaloupe, or a chunk of watermelon. She cooked with plenty of onions, oregano, and other herbs to increase the satiety of her meals. “I discovered that the right seasonings could make low-fat foods quite satisfying,” she says.

These simple changes allowed Helen to lose what she called her extra baggage in about 6 months. These days, she eats whenever she wants to, without worrying about her weight. She just makes sure to choose “skinny” foods that satisfy.

WINNING ACTION

Fill up on fiber-rich foods. Helen’s strategy of eating filling low-fat, low-calorie, high-fiber foods is smart for two reasons. First, fiber helps absorb fat calories and eliminate them from your body before they end up on

your belly or thighs. In fact, gram of fiber can absorb calories of fat. Second, fiber fills you up. Avoiding feelings of deprivation is critical to adopting permanent dietary changes.

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